| NPI | 1215537121 |
|---|---|
| Other Name | DIMA PUCHKAREV |
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: CA 127235) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2020-10-29 |
| Last Update Date | 2025-04-18 |